Taylor Swift named her new song Patient Zero. Where does the term originate?

NEW YORK – The arrival of new Taylor Swift music has a tendency to send fans and internet sleuths on a quest for meanings hidden in her lyrics. The pop idol’s announcement of four new songs, to be released on Sept 25, was no different.

In a social media post, she highlighted one track, Patient Zero. Articles were dedicated this week to piecing together clues about the song.

But the term “patient zero” has its own complex history. It has become part of the cultural lexicon, used in films and novels about dangerous pathogens. Its usage became even more common during the Covid-19 pandemic, and during a recent outbreak of hantavirus.

The term is largely viewed as a misnomer in the medical and science communities, and it can invite stigma and alarm.

Here is how it was created decades ago by accident, how its usage has changed over time and a hint at what Swift may actually be getting at.

What is the origin story of ‘patient zero’?

“Patient zero” has its roots in the AIDS crisis, when health investigators were trying to track the early spread of the virus in the 1980s. A study identified one French Canadian man, Gaetan Dugas, as the link between several California cases. The researchers labelled him as “Patient O”, short for “Out of California”.

But other researchers began to misread the letter “O” as “zero”, and many mistook the man at the centre of the cases as “patient zero”.

“The phrase ‘patient zero’ has been deeply consequential for numerous individuals who have been caught up in its suggestive pointing,” said Richard A. McKay, a researcher at the University of Cambridge who is also the author of Patient Zero and the Making of the AIDS Epidemic.

What was the effect?

Researchers and health officials say that finding the origins of a pathogen is critical to better understanding and controlling its spread.

But when the public is already on edge during an outbreak – or worse, a pandemic – a focus on a “patient zero” can cause alarm, create a deep stigma tied to the individual or fuel scapegoating of the group to which a person belongs.

Take Dugas. He was once blamed for starting the entire American AIDS epidemic and the more than 61,000 deaths it had caused by the end of 1988. The media latched onto the idea and vilified him, with The New York Post even describing Dugas in a headline as The Man Who Gave Us AIDS.

“The desire to pinpoint a beginning also leapfrogs over the ability to support that with observations and data,” McKay said.

“The transmission dynamics of epidemics are a lot messier than what the story and the idea of a ‘patient zero’ is seeking to find.”

Dugas, who died in 1984, was exonerated 10 years ago by a team led by Michael Worobey of the University of Arizona through a genetic analysis of stored blood samples and historical detective work.

How has ‘patient zero’ changed over time?

McKay, while writing his book, often looked to Mosby’s Medical Dictionary, a comprehensive reference.

“Patient zero” appeared for the first time in the book’s 1998 edition and was not removed until its 2017 edition, he said.

That did not mean the term had been phased out of public, non-expert use. During the coronavirus pandemic it seemed to be uttered everywhere as people locked themselves indoors and health officials sought the origin of the virus.

Even Steve Wozniak, the co-founder of Apple, said in a 2020 social media post that he and his wife might have been “patient zero” in the United States. He later said the post “was kind of a joke”.

The term is “more self referential now, and also in the way that outbreaks are reported in the media and in fictional representations”, McKay said.

“There are a lot of people that don’t understand the history and reach for the phrase because it sounds like what they think it should mean,” McKay added.

But why is it the name of a Taylor Swift song?

It is impossible to say whether Swift knows the entire history, but there are hints to her title choice.

This week, Swifties were quick to point to a 2024 Los Angeles Times column by Amy Kaufman about Swift’s whirlwind romance with her now husband, Travis Kelce.

In describing her cultural significance, Kaufman wrote that Swift was “patient zero for emotional contagion”, referring to the empathy that the pop star elicits from her fans.

Have other songs used ‘patient zero?’

The phrase has become so common that it is not readily associated with some of the connotations of its history.

The 2017 song Patient Zero by singer Aimee Mann depicts an idealistic Hollywood newcomer getting worn down by fame.

And the Swift song, along with the article that might have inspired it, have adopted their own interpretations of the two words.

The term moves “rapidly and easily between epidemiology, to news media to common figure of speech”, McKay said.

“This is perhaps a natural evolution.” NYTIMES